PDF(Pubmed)
Abstract：
UNASSIGNED: The relationship between English proficiency (EP), Glasgow Coma Scale (GCS) and traumatic brain injury (TBI) is not well characterized. We aimed to understand the impact of limited English proficiency (LEP) on the evaluation and outcomes of TBI.
UNASSIGNED: Retrospective comparative study in a single institution of patients aged ⪰65 who presented to the emergency department after a fall with head strike between January 2018 and December 2021. TBI was defined as documented loss of consciousness or intracranial hemorrhage (ICH). Relationships between EP, GCS, and TBI were analyzed with multivariable and propensity score-matched models.
UNASSIGNED: Of the 2905 included, 1233 (42%) had LEP. Most LEP patients were Asian (60%) while the majority of EP patients were non-Hispanic Caucasians (72%). In a univariate analysis, LEP had higher incidence of decreased GCS and was strongly correlated with risk of TBI (OR 1.47, CI 1.26 to 1.71). After adjusting for multiple covariates including race, LEP did not have a significantly increased risk for GCS score <13 (OR 1.66, CI 0.99 to 2.76) or increased risk of TBI. In the matched analysis, LEP had a small but significantly higher risk of GCS score <13 (OR 1.03, CI 1.02 to 1.05) without an increased risk in TBI. Decreased GCS remained strongly correlated with presence of ICH in LEP patients in the adjusted model (OR 1.39, CI 1.30 to 1.50).
UNASSIGNED: LEP correlated with lower GCS in geriatric patients with TBI. This association weakened after adjusting for factors like race, suggesting racial disparities may have more influence than language differences. Moreover, GCS remained effective for predicting ICH in LEP individuals, highlighting its value with suitable translation resources.
UNASSIGNED: This is a Level III evidence restrospective comparative study.
UNASSIGNED: Retrospective comparative study in a single institution of patients aged ⪰65 who presented to the emergency department after a fall with head strike between January 2018 and December 2021. TBI was defined as documented loss of consciousness or intracranial hemorrhage (ICH). Relationships between EP, GCS, and TBI were analyzed with multivariable and propensity score-matched models.
UNASSIGNED: Of the 2905 included, 1233 (42%) had LEP. Most LEP patients were Asian (60%) while the majority of EP patients were non-Hispanic Caucasians (72%). In a univariate analysis, LEP had higher incidence of decreased GCS and was strongly correlated with risk of TBI (OR 1.47, CI 1.26 to 1.71). After adjusting for multiple covariates including race, LEP did not have a significantly increased risk for GCS score <13 (OR 1.66, CI 0.99 to 2.76) or increased risk of TBI. In the matched analysis, LEP had a small but significantly higher risk of GCS score <13 (OR 1.03, CI 1.02 to 1.05) without an increased risk in TBI. Decreased GCS remained strongly correlated with presence of ICH in LEP patients in the adjusted model (OR 1.39, CI 1.30 to 1.50).
UNASSIGNED: LEP correlated with lower GCS in geriatric patients with TBI. This association weakened after adjusting for factors like race, suggesting racial disparities may have more influence than language differences. Moreover, GCS remained effective for predicting ICH in LEP individuals, highlighting its value with suitable translation resources.
UNASSIGNED: This is a Level III evidence restrospective comparative study.
摘要：
■英语水平（EP），格拉斯哥昏迷量表（GCS）和创伤性脑损伤（TBI）的特征不明确。我们旨在了解有限的英语水平（LEP）对TBI评估和结果的影响。
■在2018年1月至2021年12月之间因头部罢工而跌倒后向急诊科就诊的65岁患者的单一机构进行了回顾性比较研究。TBI定义为有记录的意识丧失或颅内出血（ICH）。EP之间的关系，GCS,和TBI采用多变量和倾向得分匹配模型进行分析。
■在包含的2905中，1233（42%）有LEP。大多数LEP患者是亚洲人（60％），而大多数EP患者是非西班牙裔高加索人（72％）。在单变量分析中，LEP降低GCS的发生率较高，并且与TBI的风险密切相关（OR1.47，CI1.26至1.71）。在调整包括种族在内的多个协变量后，LEP没有显著增加GCS评分<13（OR1.66，CI0.99至2.76）的风险或增加TBI的风险。在匹配分析中，LEP的GCS评分<13（OR1.03，CI1.02至1.05）的风险较小但显着较高，而TBI的风险却没有增加。在校正模型中，LEP患者中GCS降低与ICH的存在密切相关（OR1.39，CI1.30至1.50）。
■LEP与老年TBI患者GCS降低相关。在调整了种族等因素后，这种联系减弱了，这表明种族差异可能比语言差异有更大的影响。此外，GCS仍然有效预测LEP个体的ICH，用合适的翻译资源突出其价值。
■这是一项III级证据再前瞻性比较研究。
■在2018年1月至2021年12月之间因头部罢工而跌倒后向急诊科就诊的65岁患者的单一机构进行了回顾性比较研究。TBI定义为有记录的意识丧失或颅内出血（ICH）。EP之间的关系，GCS,和TBI采用多变量和倾向得分匹配模型进行分析。
■在包含的2905中，1233（42%）有LEP。大多数LEP患者是亚洲人（60％），而大多数EP患者是非西班牙裔高加索人（72％）。在单变量分析中，LEP降低GCS的发生率较高，并且与TBI的风险密切相关（OR1.47，CI1.26至1.71）。在调整包括种族在内的多个协变量后，LEP没有显著增加GCS评分<13（OR1.66，CI0.99至2.76）的风险或增加TBI的风险。在匹配分析中，LEP的GCS评分<13（OR1.03，CI1.02至1.05）的风险较小但显着较高，而TBI的风险却没有增加。在校正模型中，LEP患者中GCS降低与ICH的存在密切相关（OR1.39，CI1.30至1.50）。
■LEP与老年TBI患者GCS降低相关。在调整了种族等因素后，这种联系减弱了，这表明种族差异可能比语言差异有更大的影响。此外，GCS仍然有效预测LEP个体的ICH，用合适的翻译资源突出其价值。
■这是一项III级证据再前瞻性比较研究。
